Outer Branches Research Articles

Latitudinal Distribution of Dayside Magnetospheric Currents Based on Cluster Observations

AbstractBased on the curlometer method, we calculate the azimuthal component of the current density from nearly 19 years of Fluxgate Magnetometer (FGM) data of Cluster and investigate its latitudinal distribution in the dayside noon sector (09:00–15:00 magnetic local time, MLT). A crossing event in the noon meridian plane shows an unexpected eastward current at a geocentric distance of 8 RE, away from the equator with latitudes of 30–40°. Further statistical results of the current distribution show that, the topology of the current can be radially divided into the inner and outer branches over the whole rxy − z plane (rxy = and z are in solar magnetic (SM) coordinates), with the separation point of these two branches at a geocentric distance of about 8 RE. The current variations of the inner and outer branches are different under different Kp, solar wind flow speed Vsw, and solar wind dynamic pressure Pdyn. It is shown that the current densities in both the inner and outer branches increase significantly with the Kp. High solar wind dynamic pressure enhances the current density of the outer branch, while high solar wind speed, on the contrary, enhances that of the inner branch. The formation of the outer branch may be related to the anisotropy of plasma pressure.

Endovascular Treatment of Complex Aortic Aneurysms Using Inner Branch Device (IBEVAR): A Single Center Experience

Abstract Background Due to advances in devices and techniques, the endovascular approach using fenestrated or branched endografts has emerged as a valid and safe alternative for patients with complex aortic aneurysms, especially if considered at high risk for surgery. The use of inner branch devices (iBEVAR) combining benefits of fenestrations and outer branches could offer an ideal configuration in this context. Aims The aim of our study was to report our monocentric experience with iBEVAR in the treatment of complex aortic aneurysms. Methods A retrospective analysis of prospective data retrieved from 1 center between January 2020 and January 2024 was done. Endpoints were immediate technical success, postoperative morbidity, rate of re-intervention and mortality. Results During this period, 72 patients with a mean age of 68.5 years (range 41-88) were identified. The maximum preoperative mean aortic diameter was 56 mm (44-71 mm). The majority of patients was asymptomatic. For diffuse thoraco-abdominal aortic aneurysms, a 2-steps procedure was used. There were 34 off-the-shelf E-nside (47%) and the remaining 38 patients were treated with a custom-made Extra-Design graft (53%). Despite successful endograft deployment in all patients and branch catheterization in 69/72 cases (96%), the technical success was 94% due to an additional open conversion for ilio-mesenteric bypass. The 30-days mortality was 5.5%. During the post-operative period, 19% of patients presented complications with 1 case of mesenteric ischaemia requiring a visceral resection and 2 cases of paralytic ileus, treated conservatively. 5 cases (6.9) of spinal cord ischemia were observed. During the median follow-up, 22 patients (31%) had a re-intervention, for endoleaks, bridging-stent events or limbs problems. The overall target vessel patency was 94%. Conclusion The use of iBEVAR appears to be safe and effective for the treatment of complex aortic aneurysms with an acceptable rate of complications. Strict follow-up is mandatory and about one-third of patients required a re-intervention. Further patients and longer follow-up are needed.

Dean vortex-enhanced blood plasma separation in self-driven spiral microchannel flow with cross-flow microfilters

Point-of-care (POC) diagnostic devices have been developing rapidly in recent years, but they are mainly using saliva instead of blood as a test sample. A highly efficient self-separation during the self-driven flow without power systems is desired for expanding the point-of-care diagnostic devices. Microfiltration stands out as a promising technique for blood plasma separation but faces limitations due to blood cell clogging, resulting in reduced separation speed and efficiency. These limitations are mainly caused by the high viscosity and hematocrit in the blood flow. A small increment in the hematocrit of the blood significantly increases the pressure needed for the blood plasma separation in the micro-filters and decreases the separation speed and efficiency. Addressing this challenge, this study explores the feasibility of diluting whole blood within a microfluidic device without external power systems. This study implemented a spiral microchannel utilizing the inertial focusing and Dean vortex effects to focus the red blood cells and extract the blood with lower hematocrit. The inertial migration of the particles during the capillary flow was first investigated experimentally; a maximum of 88% of the particles migrated to the bottom and top equilibrium positions in the optimized 350 × 60 μm (cross-sectional area, 5.8 aspect ratio) microchannel. With the optimized dimension of the microchannel, the whole blood samples within the physiological hematocrit range were tested in the experiments, and more than 10% of the hematocrit reduction was compared between the outer branch outlet and inner branch outlet in the 350 × 60 μm microchannel.

Off the Shelf Multibranched Endograft for Thoraco-Abdominal and Pararenal Abdominal Aortic Aneurysms: a Prospective, Single Centre Study of the G-Branch Endograft

To investigate outcomes of a novel, off the shelf multibranched endovascular stent graft for the treatment of thoraco-abdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm (PAAA). A prospective, single centre study including 15 patients (mean age, 63.4 ± 10.7 years; 13 male) with TAAA or PAAA treated from October 2019 to March 2021 with a G-Branch endograft (Lifetech Scientific, Shenzhen, China) featuring a mixed multibranch design with two inner and two outer branches for reconstruction of the visceral and bilateral renal arteries, respectively. Follow up assessments were scheduled before discharge and at 30 days, six and 12 months after the index procedure. Annual telephone interviews were performed beyond the initial 12 months. The Kaplan-Meier method was used to estimate cumulative mortality and morbidity rates after endovascular repair. Technical success was achieved in all 15 patients. Nine patients (60%) had TAAA and six (40%) had PAAA (mean maximum aneurysm diameter, 73.7 ± 15.8 mm). The median follow up was 31.4 months (range, 10.1 - 44.0 months). At 30 days, there was no death and 7% morbidity (one case of temporary spinal cord ischaemia on Day 4). At one year, the mortality rate was 7% (one death from stroke at 10 months) and morbidity was 13% (one other case of renal function decline at six months). There were no aneurysm dilatations, re-interventions, or access related complications, and two (13%) persistent type II endoleaks. The one year primary branch patency rate was 100% for the four renovisceral arteries in all 13 patients who underwent computed tomography examinations. One patient died of hepatocellular carcinoma 29 months post-operatively, resulting in an estimated three year mortality rate of 13%. The G-Branch endograft yielded high technical success with good early and midterm outcomes for the treatment of TAAA and PAAA. A large multicentre study is warranted.

Three-dimensional reconstruction of cotton plant with internal canopy occluded structure recovery

The inner leaves of crop canopies are obscured by outer branches and leaves, leading to information loss and observation difficulty of the occluded canopy structure using modern crop monitoring techniques. It has restricted the development of phenotypic analysis and precision agriculture. In this paper, we propose a neural network approach to reconstruct the occluded structure of crop canopies with an RGB-D sensor. Taking the cotton plant as the object of study, we propose a novel Cascade Leaf Segmentation and Completion Network (CLSCN) to reconstruct the occluded leaf images and propose a Fragmental Leaf Point–cloud Reconstruction Algorithm (FLPRA) to complete the missing point clouds. By combining the Instance Segmentation Network (ISN), Generative Adversarial Network (GAN) and Point-cloud Reconstruction Algorithm (PRA), the three-dimensional models of cotton plants with both completed internal and external structures of the canopy are smoothly reconstructed. Firstly, we collect a large number of leaf images and point clouds of cotton plants using an RGB-D sensor with the top view and construct a manually labeled cotton leaf dataset for training and evaluation. Secondly, a network named CLSCN is cascading constructed with an Instance Segmentation Network (ISN) and a Generative Adversarial Network (GAN), and the two parts of CLSCN are separately trained with our constructed dataset to output complete cotton leaves. Thirdly, with the fusion of the completed RGB images output by cascaded network segmentation and the point clouds captured by RGB-D sensor, the proposed FLPRA is used to filter, reconstruct, fuse and register the cotton canopy leaf point clouds, and to obtain the whole cotton canopy point-clouds with inner occluded structure recovery. Finally, the CLSCN and FLPRA are validated using the validation dataset of cotton leaf. The test results indicate that the front-end ISN of the proposed CLSCN can generate high-quality cotton leaf masks, with FID scores less than 35 and mIoU up to 84.65%. Additionally, the back-end GAN of CLSCN can complete the occluded leaves with an accuracy of over 94%. The reconstruction accuracy of the final three-dimensional model of the cotton canopy is as high as 82.70%. Therefore, the proposed neural network and algorithm effectively solve the problem of incomplete canopy point cloud caused by the occlusion of outer leaves and provide an effective way to recover the complete three-dimensional structure of crop canopy with internal occlusion. It is a meaningful theoretical and technical support to realize real-time crop status observation and precise field management in agriculture production.

Effect of narrow paravisceral aorta on target vessel instability after fenestrated and branched endovascular aortic repair

ObjectiveTo investigate the effect of narrow paravisceral aorta (NPA) on target vessel instability (TVI) after fenestrated-branched endovascular aortic repair. MethodsWe conducted a single-center retrospective study (2014-2023) of patients treated by fenestrated-branched endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAA) or pararenal aortic aneurysms. The paravisceral aorta was defined as the aortic segment limited by the diaphragmatic hiatus proximally and the emergence of lower renal artery distally, and was considered “narrow” in case of a minimum inner diameter of <25 mm. The minimum aortic diameter, location, longitudinal extension, angulation, calcification, and thrombus thickness of NPA were evaluated at the preoperative computed tomography angiogram. End points were 30-day technical success and freedom from TVI. ResultsThere were 142 patients with JRAA/pararenal aortic aneurysm (n = 85 [59%]) and extent IV (n = 24 [17%]) or extent I-III (n = 33 [23%]) TAAA, with 513 target arteries successfully incorporated through a fenestration (n = 294 [57%]) or directional branch (n = 219 [43%]). A NPA was present in 95 patients (70%), 73 (86%) treated by fenestrated endovascular aortic repair (FEVAR) and 22 (39%) by branched endovascular aortic repair (BEVAR). The overall 30-day mortality was 2% and technical success was 99%, without differences between NPA and non-NPA (P = .99). Kaplan-Meier estimated freedom from TVI at 4 years was 82%, 81% (95% CI, 75-95) in patients with a NPA and 80% (95% CI, 68-94) and in those without NPA (P = .220). The result was maintained for both FEVAR (NPA: 81% [95% CI, 62-88]; non-NPA: 76% [95% CI, 60-99]; P = .870) and BEVAR (NPA: 77% [95% CI, 69-99]; non-NPA: 80% [95% confidence interval (CI) 66-99]; P = .100). After multivariate analysis, the concomitant presence of a NPA <20 mm and angulation of >30° was significantly associated with TVI in FEVAR (HR, 3.21; 95% CI, 1.03-48.70; P = .036), being the result mostly driven by target vessel occlusion. In BEVAR, a NPA diameter of <25 mm was not associated with TVI (HR, 2.02; 95% CI, 0.59-5.23; P = .948); after multivariate analysis, the use of outer branches in case of a NPA longitudinal extension of >25 mm (hazard ratio [HR], 3.02; 95% CI, 1.01-36.33; P = .040) and NPA severe calcification (HR, 1.70; 95% CI, 1.00-22.42; P = .048) were associated with a higher chance for TVI. ConclusionsFEVAR and BEVAR are both feasible in cases of NPA and provide satisfactory target vessels durability. The use of outer branches should be avoided in cases with an inner aortic diameter of <25 mm with a longitudinal extension of >25 mm or moderate to severe NPA calcifications. In FEVAR, bridging stent patency may be negatively influenced by NPA of <20 mm in association with aortic angulation of >30°.

Endovascular Treatment of Chronic Post-Dissection Thoraco-Abdominal Aneurysms Using Inner Branch Device (Ibevar): A Preliminary Single Center Experience

Abstract Background Although open surgery remains the gold standard for the treatment of post-dissection thoraco-abdominal aneurysms (TAAAs), the endovascular approach using fenestrated or branched endografts has emerged as a valid alternative for patients considered at high risk for surgery. The use of inner branch devices (iBEVAR) combining benefits of fenestrations and outer branches could offer an ideal configuration in this context. Aims Our aim was to report our preliminary monocentric experience with iBEVAR in the treatment of post-dissection TAAAs. Methods A retrospective analysis of prospective data retrieved from 1 center between Mars 2020 and January 2023 was done. Endpoints were immediate technical success, postoperative morbidity, rate of endoleaks, re-intervention and mortality. Results During this period, 18 patients (mean age 66,5 years, range 41-80) were identified. All were asymptomatic and operated in a 2-steps procedure with a TEVAR first. There were 5 off-the-shelf E-nside (28%) and 13 custom-made Extra-Design grafts (72%). Despite successful endograft deployment in all patients and branch catheterization in 68/70 cases (97%), the technical success was 94% due to an open conversion for ilio-mesenteric bypass. The 30-days mortality was 0%. During the post-operative period, 17% of patients (3/18) presented complications with 1 case of mesenteric ischaemia requiring a visceral resection and 2 cases of paralytic ileus, treated conservatively. No spinal cord ischemia was observed. During the median follow-up of 16 months (range 1-36), 4 patients (22%) had a re-intervention: one case of type-Ic endoleak treated with an additional renal stent and 3 cases of type-III endoleaks in the celiac trunk requiring a relining. The overall target vessel patency was 100%. In all cases, the sac diameter remained stable. Conclusions The use of iBEVAR appears to be safe and effective for the treatment of post-dissection TAAAs with an acceptable rate of complications. Further patients and longer follow-up are needed.

Effect of Narrow Paravisceral Aorta on Target Vessel Instability After Fenestrated-Branched Endovascular Aortic Repair

The aim of this study was to investigate the effect of narrow paravisceral aorta (NPA) on target vessels instability (TVI) after fenestrated-branched endovascular aortic repair (F-BEVAR). We conducted a single-center retrospective study (2014-2022) on patients treated by F-BEVAR for thoracoabdominal (TAAAs) or pararenal aortic aneurysms (PRAAs). Paravisceral aorta was defined as the aortic segment limited by the diaphragmatic hiatus proximally and the emergence of lower renal artery distally and was considered “narrow” in case of minimum inner diameter <25 mm. Minimum aortic diameter, location, longitudinal extension, angulation, calcification, and thrombus thickness of NPA were evaluated at the preoperative computed tomography angiogram. Endpoints were technical success and freedom TVI (target vessel-related death, occlusion, rupture or reintervention for stenosis, endoleak, or disconnection). Kaplan-Meier estimates and Cox proportional hazards were used for analysis. Three hundred ninety-five incorporated target arteries were analyzed (110 patients; 50 TAAAs and 60 PRAAs), 214 fenestrations (54%), 102 outer branches (26%), and 79 inner branches (20%). NPA was present in 59 patients (54%), accounting for 202 target vessels (136 fenestrations, 44 inner branches, and 22 outer branches); the non-NPA group had 193 target vessels (78 fenestrations, 35 inner branches, and 80 outer branches). Overall technical success was 99% (NPA: 99%, Non-NPA: 99%; P = .879). Overall freedom from TVI at 4 years was 91% ± 5% (NPA: 90% ± 6%, non-NPA: 93% ± 6%; P = .752). After stratification by endograft design, NPA was not associated with TVI (fenestrations: hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.04-3.47; P = .442; inner branches: HR, 2.25; 95% CI, 0.47-16.25; P = .343; outer branches: HR, 1.09; 95% CI, 0.27-4.17; P = .891). The association of use of outer branches in NPA plus location at the level of the aortic zone 6 (from the origin of the celiac artery to the superior mesenteric artery), longitudinal extension >25 mm, or aortic wall moderate/severe calcifications, was cause of worsened freedom from TVI (P = .043; P = .031; and P = .045; respectively). Thrombus thickness (HR, 1.03; 95% CI, 0.93-1.13; P = .536) and angulation (HR, 1.02; 95% CI, 0.94-1.18; P = .602) of NPA were not significantly associated. NPA <20 mm was a negative predictor for bridging stents patency (HR, 1.12; 95% CI, 1.09-6.99; P = .028) with the use of fenestrations. FEVAR and BEVAR are both feasible in cases of NPA, and overall provide satisfactory target vessels durability. The use of outer branches should be avoided in cases with inner aortic diameter <25 mm at the level of the aortic zone 6, with longitudinal extension >25 mm, or moderate/severe NPA calcifications. In FEVAR, bridging stent patency may be negatively influenced by NPA<20 mm.

Numerical analysis of multi-regime combustion using flamelet generated manifolds - a highly-resolved Large-Eddy Simulation of the Darmstadt multi-regime burner

Multi-regime effects occur due to the interaction of combustion phenomena such as partial premixing of reactants or product-recirculation and lead to the invalidity of idealization of local reaction zones by purely premixed or purely non-premixed flame structures. The recently proposed multi-regime burner (MRB) at the Hochschule Darmstadt and the TU Darmstadt is investigated using highly-resolved Large-Eddy Simulation (LES) regarding the present combustion modes – with focus on MILD combustion – and overall flame characteristics. Thermochemical experimental data and highly resolved LES are compared for two selected operating conditions MRB18b and MRB26b. The experimental investigation focuses on the overall flame structure by examining radial profiles of temperature and mixture fraction, as well as scatter plots of temperature and CH4 versus mixture fraction. The objective of this analysis is to provide insights into the reaction zone structure which are difficult to extract by experimental means, by using highly-resolved Large-Eddy Simulations under flow conditions representative of MRB18b and MRB26b. The generated database was used to allow for a separate analysis of the inner and outer flame branches. SO2 measurements were analyzed together with the simulated temperature fields to further assess the flame stabilization mechanism in this configuration. The importance of different flame zones and burning modes was analyzed using the flame index and temperature locus diagrams. The effects of the flame zones are found to evolve with the downstream distance and show distinct differences between the two operating conditions. The applied diagnostics reveal the spatial and thermodynamical state of the different regimes.

Drone-assisted collection of environmental DNA from tree branches for biodiversity monitoring.

The protection and restoration of the biosphere is crucial for human resilience and well-being, but the scarcity of data on the status and distribution of biodiversity puts these efforts at risk. DNA released into the environment by organisms, i.e., environmental DNA (eDNA), can be used to monitor biodiversity in a scalable manner if equipped with the appropriate tool. However, the collection of eDNA in terrestrial environments remains a challenge because of the many potential surfaces and sources that need to be surveyed and their limited accessibility. Here, we propose to survey biodiversity by sampling eDNA on the outer branches of tree canopies with an aerial robot. The drone combines a force-sensing cage with a haptic-based control strategy to establish and maintain contact with the upper surface of the branches. Surface eDNA is then collected using an adhesive surface integrated in the cage of the drone. We show that the drone can autonomously land on a variety of branches with stiffnesses between 1 and 103newton/meter without prior knowledge of their structural stiffness and with robustness to linear and angular misalignments. Validation in the natural environment demonstrates that our method is successful in detecting animal species, including arthropods and vertebrates. Combining robotics with eDNA sampling from a variety of unreachable aboveground substrates can offer a solution for broad-scale monitoring of biodiversity.

Outer space branching search method for solving generalized affine fractional optimization problem

&lt;abstract&gt;&lt;p&gt;This paper proposes an outer space branching search method, which is used to globally solve the generalized affine fractional optimization problem (GAFOP). First, we will convert the GAFOP into an equivalent problem (EP). Next, we structure the linear relaxation problem (LRP) of the EP by using the linearization technique. By subsequently partitioning the initial outer space rectangle and successively solving a series of LRPs, the proposed algorithm globally converges to the optimum solution of the GAFOP. Finally, comparisons of numerical results are reported to show the superiority and the effectiveness of the presented algorithm.&lt;/p&gt;&lt;/abstract&gt;

Investigation of the surface temperature in contact with plasma by two-color pyrometry

A high-speed two-color pyrometer has been developed that allows measuring the intensity of thermal radiation in temperature range of 100-3500oC with 2 μs time resolution. The analysis of the main factors affecting the measurement of surface temperature in the conditions of its interaction with plasma is carried out. It is shown that at plasma temperature of more than 10 eV and moderate concentration of particles, the wall plasma can be considered transparent to thermal radiation. Experimental studies on non-contact measurement of temperature of surface interacting with plasma on Globus-M2 tokamak and plasma gun test bench have been carried out. Sawtooth temperature fluctuations were detected on the wall of tokamak chamber near the exit of outer separatrix branch. The period of these flashes was 3-4 ms, and duration was 2 ms. The maximum wall temperature measured by a high-speed pyrometer exceeded the temperature measured by infrared camera. Measurements of temperature of the front surface of W-Li sample were carried out at plasma gun test bench under conditions of deuterium plasma jet cyclic action under loads simulating regimes of plasma current disruption in tokamak. The sample temperature reached more than 3000^oC during &amp;lt;1 ms. The thermal conductivity of the sample degraded with an increase in number of plasma exposure cycles, which was expressed in progressive decrease in target cooling rate after the pulse. Using a high-speed pyrometer, it is proposed to control the formation of heat-insulating foils on surface interacting with plasma Keywords: two-color pyrometer, thermal radiation, surface temperature, materials irradiation.

Исследование температуры поверхности, контактирующей с плазмой, методом двухцветной пирометрии

A high-speed two-color pyrometer has been developed that allows measuring the intensity of thermal radiation in temperature range of 100-3500 0C with 2 µs time resolution. The analysis of the main factors affecting the measurement of surface temperature in the conditions of its interaction with plasma is carried out. It is shown that at plasma temperature of more than 10 eV and moderate concentration of particles, the wall plasma can be considered transparent to thermal radiation. Experimental studies on non-contact measurement of temperature of surface interacting with plasma on Globus-M2 tokamak and plasma gun test bench have been carried out. Sawtooth temperature fluctuations were detected on the wall of tokamak chamber near the exit of outer separatrix branch. The period of these flashes was 3-4 ms, and duration was 2 ms. The maximum wall temperature measured by a high-speed pyrometer exceeded the temperature measured by infrared camera. Measurements of temperature of the front surface of W-Li sample were carried out at plasma gun test bench under conditions of deuterium plasma jet cyclic action under loads simulating regimes of plasma current disruption in tokamak. The sample temperature reached more than 3000 0C during &lt; 1 ms. The thermal conductivity of the sample degraded with an increase in number of plasma exposure cycles, which was expressed in progressive decrease in target cooling rate after the pulse. Using a high-speed pyrometer, it is proposed to control the formation of heat-insulating foils on surface interacting with plasma.

Model construction and validation of airflow velocity attenuation through pear tree canopies.

To investigate the airflow velocity attenuation inside pear tree canopies and the factors that influence its effect on air-assisted spraying, the relationship between the resistance of the canopies to airflow and airflow velocity inside the canopies was determined. At the same time, the theoretical model of airflow velocity attenuation in the canopy was constructed, in which the velocity attenuation factor k and the incoming velocity were the model input values, and the airflow velocity in the canopy was the model output value. Then, experimental verification of the theoretical model was completed. The determination test of airflow velocity inside canopies with three leaf area densities revealed that the error range between the established theoretical model and the experimental airflow velocity inside the pear tree canopy was 0.11-1.25 m/s, and the mean size of the model accuracy was 83.4% under various working conditions. The results revealed that the region from a depth of 0m to 0.3m inside the canopy was the rapid attenuation area of the airflow and that from 0.3m to 0.9m was the low attenuation area. Furthermore, they revealed that high-speed airflow could strongly disturb the outer branches and leaves, greatly changing the windward area of the canopy blades and thus affecting the accuracy of the model. By introducing a dynamic parameter of the canopy leaf windward area for model correction, the R2 of the model was above 0.9. Finally, validation of the model was performed in an air-assisted spraying operation in an orchard. This study can provide a theoretical basis for the regulation of airflow parameters of air-assisted spraying of pear trees.

Risk factors for target vessel endoleaks after physician-modified fenestrated or branched endovascular aortic repair for postdissection thoracoabdominal aortic aneurysms

ObjectivePatients with postdissection thoracoabdominal aortic aneurysms (TAAAs) have been more likely to develop endoleaks than those with degenerative TAAAs after fenestrated or branched endovascular aortic repair (F/BEVAR). In the present study, we aimed to determine the risk factors for target vessel (TV)-related endoleaks after visceral segment F/BEVAR for postdissection TAAAs. MethodsWe performed a retrospective analysis of all patients with degenerative and postdissection TAAAs treated with F/BEVAR between 2017 and 2021. All the patients had undergone computed tomography angiography before and 3 months, 6 months, and annually after discharge. Two experienced vascular surgeons had used data from computed tomography angiography and vascular angiography to judge the presence of endoleaks. The study end points were mortality, aneurysm rupture, and the emergence of and reintervention for TV-related endoleaks. ResultsA total of 195 patients (mean age, 66 ± 10 years; 69% men) had undergone F/BEVAR for 99 postdissection TAAAs and 96 degenerative TAAAs. During a mean follow-up of 16 ± 12 months, we found that the patients with postdissection TAAAs were younger (age, 64 ± 10 years vs 69 ± 9 years; P = .001), had required more prior aortic repairs (58% vs 40%; P = .012), and had had a higher body mass index (26.1 ± 3.4 kg/m2 vs 24.8 ± 3 kg/m2; P = .008), a larger visceral segment aortic diameter (47.1 ± 7.5 mm vs 44.5 ± 7.5 mm; P = .016), and more TV-related endoleaks (18% vs 7%; P = .023) compared with those with degenerative TAAAs. Of the 99 patients with postdissection TAAAs, 327 renal–mesenteric arteries were revascularized using 12 scallops, 141 fenestrations, and 174 inner or outer branch stents. A total of 25 TV-related endoleaks were identified among 18 patients during follow-up, including 6 type Ic (retrograde from the distal end of the branch), 3 type IIIb (bridging stent fabric tear), and 16 type IIIc endoleaks (detachment or loose connection of the bridging stent). The patients with an endoleak had had a larger visceral aortic diameter (52.7 ± 6.4 mm vs 45.8 ± 7.2 mm; P < .001) and had undergone revascularization of more TVs (3.7 ± 0.7 vs 3.2 ± 0.9; P = .032). In contrast, true lumen compression did not seem to affect the occurrence of TV endoleaks (39% vs 27%; P = .323). The use of presewn branch stents in the fenestration position was associated with a lower risk of TV-related endoleaks (5% vs 11%; P = .025). In addition, TVs derived entirely or partially from the false lumen were more prone to the development of endoleaks after reconstruction (19% vs 4% [P < .001]; and 15% vs 4% [P = .047], respectively). ConclusionsWe found that patients with postdissection TAAAs were more likely to have TV-related endoleaks after F/BEVAR in the visceral region than those with degenerative TAAAs. Additionally, patients with a larger aortic diameter and a greater number of fenestrations in the visceral region were more likely to have experienced TV-related endoleaks. Branch vessels deriving from the false lumen were also more likely to develop endoleaks after reconstruction, and prefabricated branch stents were related to a lower possibility of TV-related endoleaks.

Status of the Inner Branches in Complex Endovascular Aortic Repair

Complex endovascular therapy of the aorta with fenestrated and branched endografts plays an essential role in modern vascular medicine. Innovative solutions for demanding aortic pathologies are therefore being constantly developed by the medical industry. The aim of this manuscript is to illustrate the growing importance of the inner branches in complex aortic repair and to show the advantages and limits of this technique with an overview of the current literature. The inner branches (iBEVAR) were therefore compared to the standard treatment options (fenestrations; [FEVAR], outer branches [BEVAR]) and the technical advantages of all platforms were evaluated. The widespread use of iBEVAR in the aortic arch stands in contrast to the thoracoabdominal aorta, which is mirrored by the scarce evidence for the thoracoabdominal inner branches. The published experience is based on smaller retrospective studies with a 1-year follow-up. The E-nside (Artivion, Hechingen, Germany) thoracoabdominal off-the-shelf inner-branch-based endograft was released 2 years ago. Its widespread deployment may increase the use of the inner branches in the thoracoabdominal aorta. Moreover, an ongoing industry-funded registry may provide new insights into the long-term durability of this innovative technique.

SARS-CoV-2 Alpha-Variant Outbreak Amongst a Partially Vaccinated Long-Term Care Facility Population in The Netherlands-Phylogenetic Analysis and Infection Control Observations.

Despite extensive vaccination and booster programs, SARS-CoV-2 outbreaks in long-term care facilities (LTCF) continue to occur. We retrospectively describe a SARS-CoV-2 outbreak amongst a partially vaccinated LTCF population in The Netherlands which occurred in March 2021. The facility comprised three floors functioning as separate wards. Nasopharyngeal swabs for SARS-CoV-2 qRT-PCR were obtained from residents and staff presenting with COVID-19-like symptoms and from all residents and staff during two point prevalence screenings (PPS). Samples meeting technical criteria were included for phylogenetic analysis. Positive SARS-CoV-2 qRT-PCR were obtained from 11 (18%) of 61 residents and 8 (7%) of 110 staff members between March 8 and March 25. Seven (37%) cases and five (63%) vaccinated cases were diagnosed through PPS. Cases were found on all wards. Phylogenetic analysis (n = 11) showed a maximum difference of four nucleotides between sequences on the outer branches of the tree, but identified two identical sequences on the root differing maximum two nucleotides from all other sequences, suggesting all did belong to the same cluster. Our results imply that PPS is useful in containing SARS-CoV-2 outbreaks amongst (vaccinated) LTCF populations, as an entire LTCF might behave as a single epidemiological unit and it is preferable to maximize the number of samples included for phylogenetic analysis.

Structure of the ethanol spray flame under conventional and MILD conditions

A numerical examination is carried out on the experimental MILD turbulent spray burner of Delft Spray in Hot Co-flow, DSHC. The RANS approach is combined with the Lagrangian tracking of droplets for modeling the pressure-swirl atomizer. The EDC combustion model is employed, to take into account detailed chemical mechanisms. Predictions show that the structure of the triple-flame of liquid fuel in the atmospheric condition is different from the conventional gaseous triple-flames. Furthermore, the structure of the MILD spray flame is compared to the non-MILD spray flame. The flame index shows that the triple-flame structure in the conventional spray flame that consists of two outer and middle diffusion branches, and a premixed inner branch converts to a double-flame structure under MILD condition, including an outer diffusion and a premixed inner branch. In another step, sensitivity analysis relative to the temperature, and oxygen concentration of the co-flow stream is performed independently, which was not possible in the experiment. The parameter of ignition delay time is used for the selection of parametric study cases. Moderate preheating could lead to deviation from the MILD combustion regime, while high preheating is beneficial. NO pollutant generation shows more sensitivity to dilution rather than preheating in MILD spray flame. This study showed that increasing or decreasing each of the temperature and oxygen concentration doesn’t improve all the effective aspects toward achieving the MILD condition. So, the effective parameters should be changed according to a specific and more precise goal.

The evolution of biramous appendages revealed by a carapace-bearing Cambrian arthropod.

Biramous appendages are a common feature among modern marine arthropods that evolved deep in arthropod phylogeny. The branched appendage of Cambrian arthropods has long been considered as the ancient biramous limb, sparking numerous investigations on its origin and evolution. Here, we report a new arthropod, Erratus sperare gen. et sp. nov., from the Lower Cambrian (Stage 3, 520 Ma) Chengjiang biota of Yunnan, China, with unique trunk appendages formed of lateral anomalocaridid-type flaps and ventral subconical endopods. These appendages represent an intermediate stage of biramous limb evolution, i.e. from 'two pairs of flap appendages' in radiodonts to 'flap + endopod' in Erratus, to 'exopod + endopod' in the rest of carapace-bearing arthropods that populate the basal region of the upper-stem lineage arthropods (deuteropods). The new species occupies a phylogenetic position at the first node closer to deuteropods than to radiodonts, and therefore pinpoints the earliest occurrence of the endopod within Deuteropoda. The primitive endopod is weakly sclerotized, and has unspecialized segments without endites or claw. The findings might support previous claims that the outer branch of the biramous limb of fossil marine arthropods, such as trilobites, is not a true exopod, but is instead a modified exite. This article is part of the theme issue 'The impact of Chinese palaeontology on evolutionary research'.

Medial Arterial Calcification: A Significant and Independent Contributor of Peripheral Artery Disease.

Over 200 million individuals worldwide are estimated to have peripheral artery disease (PAD). Although the term peripheral can refer to any outer branch of the vasculature, the focus of this review is on lower-extremity arteries. The initial sequelae of PAD often include movement-induced cramping pain in the hips and legs or loss of hair and thinning of the skin on the lower limbs. PAD progresses, sometimes rapidly, to cause nonhealing ulcers and critical limb ischemia which adversely affects mobility and muscle tone; acute limb ischemia is a medical emergency. PAD causes great pain and a high risk of amputation and ultimately puts patients at significant risk for major adverse cardiovascular events. The negative impact on patients' quality of life, as well as the medical costs incurred, are huge. Atherosclerotic plaques are one cause of PAD; however, emerging clinical data now shows that nonatherosclerotic medial arterial calcification (MAC) is an equal and distinct contributor. This ATVB In Focus article will present the recent clinical findings on the prevalence and impact of MAC in PAD, discuss the known pathways that contribute specifically to MAC in the lower extremity, and highlight gaps in knowledge and tools that limit our understanding of MAC pathogenesis.